Healthcare Provider Details

I. General information

NPI: 1306769559
Provider Name (Legal Business Name): BENJAMIN STEVEN KADAU
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 MICHIGAN AVE
HOLLAND MI
49423-4918
US

IV. Provider business mailing address

602 MICHIGAN AVE
HOLLAND MI
49423-4918
US

V. Phone/Fax

Practice location:
  • Phone: 616-392-5141
  • Fax:
Mailing address:
  • Phone: 616-392-5141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704326244
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: